NICU

Question 1

8 main things that bring bbs to the NICU?

Answer 1

1. RDS
2. Meconium aspiration syndrome
3. Hypoxic ischemic encephalopathy
4. Congenital diaphragmatic hernia
5. abdominal wall defet=cts
6. neuromuscular disorders
7. orthopaedic issues
8. PREMATURITY

Question 2

NICU is a ______ environment due to premature bbs weakened immune system

Answer 2

protected

Question 3

what is meconium?

Answer 3

thick black tar like fluid that fills bb’s intestines in womb; if bb is in distress may expel the meconium and inhale it

Question 4

Average gestation age for an infant is ____ weeks

Answer 4

40

Question 5

Bbs born at 40 weeks are referred to being born __ ___

Answer 5

at term

Question 6

Bb’s born earlier than __ weeks are considered to be premature / preterm

Answer 6

37

Question 7

Outcomes are ______ related to gestational age at birth; bbs born _____ will have a higher incidence of mortality and morbidity

Answer 7

inversely; earlier

Question 8

Age of viability in BC?

Answer 8

23 weeks

Question 9

Large role in the NICU not directly related to bb?

Answer 9

supporting family!!!

Question 10

Why does corrected gestational age matter?

Answer 10

1. for accurate ax of developmental delays

2. to reduce stress for parents (who might compare their bb to other bbs of the same chronological age?

Question 11

Until term, a bb’s CGA is calculated by taking their gestational age and adding their age in ___

Answer 11

weeks

Question 12

After term, how is CGA calculated?

Answer 12

by taking chronological age and subtracting how many months the premature baby was

Question 13

Age is corrected with CGA until about __ years

Answer 13

2

Question 14

_____ is an important predictor of outcomes

Answer 14

birthweight

Question 15

Average birth weight?

Answer 15

3500g

Question 16

Low birth weight?

Answer 16

less than 2500 g

Question 17

Very low birth weight?

Answer 17

less than 1500g

Question 18

Bb’s woh are not growing adequately in utero are described as having _______ ___ _____

Answer 18

intrauterine growth restriction

Question 19

4 common causes of prematurity ?

Answer 19

1. pregnancy of multiples
2. fetal anomalies
3. maternal health issues
4. associations with low socio-economic status/poor prenatal care

Question 20

2 resp complications of prematurity ?

Answer 20

1. bronchopulmnoary dysplasia

2. chronic lung disease

Question 21

2 neurological complications of prematurity?

Answer 21

1. intraventricular hemorrhage

2. periventricular leukomalacia

Question 22

Vision complication of prematurity ?

Answer 22

retinopathy of prematurity

Question 23

Gut complication of prematurity ?

Answer 23

necrotizing enterocolitis

Question 24

Cardiac complication of prematurity?

Answer 24

patent ductus arteriosus

Question 25

RDS is caused by a lack of ______ in premie bbs

Answer 25

surfactant

Question 26

RDS will have a ____ ____ appearance on CXR

Answer 26

ground glass

Question 27

Bronchopulmonary dysplasia (BPD) = ____ and ____ of lungs

Answer 27

scarring; stiffness

Question 28

BPD defined as O2 dependence at ___ weeks CGA

Answer 28

36

Question 29

What 2 things might BPD be accompanied by?

Answer 29

1. pulmonary HTN | 2. abnormal pulmonary vascular development

Question 30

HR of infant?

Answer 30

120-170bpm

Question 31

Bradychardia in infants?

Answer 31

HR < 100bpm

Question 32

RR of infant?

Answer 32

30-60

Question 33

Apnea in infants?

Answer 33

pause in breathing of more than 20s

Question 34

If apnea is frequent, may be treated with _____

Answer 34

caffeine

Question 35

You must keep infants SpO2 at 98-100% (T/F)

Answer 35

FALSE; too much O2 can be toxic, don't want 100%

Question 36

3 specific NICU CI's and precautions to chest PT?

Answer 36

1. active brain bleeds / potential cause for bleeds 2. brittle bones 3. be intentional with use of supplemental O2

Question 37

4 common indications for chest PT in NICU?

Answer 37

1. persistent focal atelectasis 2. cystic fibrosis 3. neuromuscular disease 4. meconium aspiration

Question 38

____-_____ ______ = important case of brain injury in premie bb's, related to disturbances in cerebral blood flow

Answer 38

intra-ventricular hemorrhage

Question 39

How is intra-ventricular hemorrhages dx ?

Answer 39

serial head US's

Question 40

Intra-ventricular hemorrhage is graded __-__, and grade __ or __ can lead to hydrocephalus which might require a shunt

Answer 40

1-4; 3-4

Question 41

Most common white matter brain injury in premature infants?

Answer 41

periventricular leukomalacia

Question 42

____ = periventricular focal necrosis with subsequent cystic formation and more diffuse cerebral white matter injury

Answer 42

PVL

Question 43

PVL highest risk under __ weeks gestational age

Answer 43

32

Question 44

Although premie bbs might have various disorders, QOL is still rated highly (T/F)

Answer 44

TRUE

Question 45

All NICU care is ____ care.

Answer 45

brain!!!

Question 46

The neonatal brain grows __ | times in volume from 24-40 weeks

Answer 46

4

Question 47

____ to _____ / ______ care = absolutely critical in NICU for bb and for parent

Answer 47

skin to skin; kangaroo

Question 48

Premie bbs require stimulation for brain developed but are easily overstimulated (T/F)

Answer 48

TRUE; try to find appropriate dose of sensory input

Question 49

5 premie stress cues?

Answer 49

1. physiologic instability (Check vitals!) 2. movement into extension / away from midline 3. finger splaying (stop sign hands!) 4. open or gaping mouth 5. hiccuping/ yawning

Question 50

5 signs of premie stability / coping?

Answer 50

1. stable vials 2. stable colour 3. movement towards flexion / midline 4. hands to mouth 5. grasping

Question 51

Short term important of positioning support?

Answer 51

lack of boundaries / support will: 1. increase agitation 2. use up more energy 3. decrease physiologic stability 4. result in poor growth

Question 52

Long term important of positioning support?

Answer 52

lack of boundaries / support: 1. bb will rest in postures that are extended and asymmetrical 2. bbs may develop plagiocephahly, retracted shoulders, extended and abducted hips, poor quality of movement

Question 53

Test of Infant Motor Performance (TIMP) is appropriate for __ weeks - __ months CGA

Answer 53

34;4